# SOUTHCOAST SPINE AND PAIN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891442869
- **Authorized official:** DARYAN LONG (BILLING MANAGER)
- **Authorized official phone:** (843) 224-8086

## Contact information

- **Practice address:** 440 SOCIETY HILL DR STE 202, AIKEN, SC 29803-1755
- **Practice address phone:** (803) 226-0102
- **Practice address fax:** (803) 226-0384
- **Mailing address:** 440 SOCIETY HILL DR STE 202, AIKEN, SC 29803-1755
- **Mailing address phone:** (803) 226-0102
- **Mailing address fax:** (803) 226-0384

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 03/09/2022
- **Last updated:** 10/06/2022